# MARSHALL COUNTY HOSP DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MARSHALL COUNTY HOSPITAL PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003921032
- **Authorized official:** PHYLLIS BLACKWELL RPH (CHIEF CLINICAL OFFICER)
- **Authorized official phone:** (270) 527-4800

## Contact information

- **Practice address:** 615 OLD SYMSONIA RD, BENTON, KY 42025-5042
- **Practice address phone:** (270) 527-4885
- **Practice address fax:** (270) 527-4893
- **Mailing address:** PO BOX 630, BENTON, KY 42025-0630
- **Mailing address phone:** (270) 527-4800
- **Mailing address fax:** (270) 527-4893

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336I0012X | Institutional Pharmacy | P05109 | KY | Yes |

## Other

- **Enumeration date:** 08/20/2006
- **Last updated:** 02/23/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2030096 | PK | — |
| 05 | — | 54025473 | — | KY |